It is so nice to be right. To summarize what I wrote almost 4 years ago, based on my experience, patients and families will accept the theoretical risk of a future cancer if it means they'll get an accurate diagnosis. A recent study validates that opinion. MedPage Today reports that before receiving any recommendation for CT scanning, 742 parents of children who presented with head injuries ...

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Recently, a family physician colleague asked me to explain why the Affordable Care Act requires private health insurers to provide first-dollar coverage for preventive services that the U.S. Preventive Services Task Force assigns an "A" or "B" (recommended) rating, but allows public insurers (Medicare and Medicaid) to determine if and how they will cover these services. Until recently, the question hadn't come up, since Medicare has agreed to cover pretty ...

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Our nation has recently witnessed another tragedy involving a young adult, with young adult victims. Facts often emerge slowly and it is important not to speculate about diagnoses through the news media; however, it seems clear in this case that mental illness is a factor -- even though few people living with mental illness are violent. To avoid tragedies, solutions are needed.  One area of real promise is early ...

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A total knee replacement is a very common operation and more than 700,000 of them are performed each year in the United States. With a mean cost of about $16,000 each, in 2011 we spent over eleven billion dollars paying for knee replacements. Projections are that, by 2030, we’ll be doing 3.5 million per year. The operation has great results and patients generally do well during and after their surgery. Anesthetic care has improved dramatically ...

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Toilet training can sometimes be a stressful process. This is particularly the case for children who achieve daytime dryness but continue to wet themselves, and the bed, overnight. It may leave you wondering what’s normal and what you can do to help your child. Nighttime wetting is one of the most common urologic conditions in childhood. The vast majority of cases are not related to a physical cause. Most commonly, nighttime ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 38-year-old man is evaluated for a 1-year history of cough with mucoid sputum and a 6-month history of mildly progressive dyspnea. He has a 12-pack-year history of smoking. He has no history of asthma, allergies, skin disease, or liver disease. On physical examination, vital signs are normal. Pulmonary examination discloses decreased breath ...

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The Ellen DeGeneres Show has repeatedly put out a call for viewers to send in their funny sunburn pictures and stories. The following was posted on the website:

Summer is here and everyone is hitting the beach or pool. Just don't forget the sunscreen! If you did, and you have the bad sunburn to prove it, we want to see the funny photos. Be sure to tell us the story behind ...

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On a cold, blustery Cleveland day when I was a resident, a forty-year-old man walked into our infectious disease clinic at the Cleveland Clinic. The patient was undergoing routine visits in preparation for a kidney transplant. This poor man had been hospitalized six months earlier at another hospital where he caught a terrible infection and was readmitted in septic shock and multi-organ failure. Luckily he survived, but in the process ...

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As a resident of San Francisco (and with Los Angeles just a drive away), I cannot escape the food hate.  Whether it be a campaign against cooked provisions, farmed products or anything of solid consistency, I cannot help but wonder if any possible benefit of these diets outweigh the risk of missing out on amazing grub. But what about gluten-free diets? Gluten sensitivity Gluten, a protein found in foodstuffs such as wheat, barley ...

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Recently, someone asked me on Twitter, “Has the change in classification of obesity as a disease affected how you treat patients presenting w/ the disease?” The classification change in question is regarding the American Medical Association’s declaration that obesity is a disease rather than a comorbidity factor. This change in classification affected 78 million American adults and 12 million children. The new status for obesity means that this is now considered a ...

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